{
"Npi": {
"NPI": "1952562191",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GA PAIN AND BEHAVIORAL MEDICINE INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
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"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "247 LANA DR",
"SecondLineMailingAddress": "P. O. BOX 1726",
"MailingAddressCityName": "GRAY",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31032-5883",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "478-986-0484",
"MailingAddressFaxNumber": "478-986-0486",
"FirstLinePracticeLocationAddress": "247 LANA DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAY",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "31032-5883",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "478-986-0484",
"PracticeLocationAddressFaxNumber": "478-986-0486",
"EnumerationDate": "06/20/2008",
"LastUpdateDate": "06/20/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SACHY",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "H",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D., M.SC., P.C.",
"AuthorizedOfficialTelephoneNumber": "478-986-0484",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "GA-043120",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}